Critical Care Fellowship Director For New Program - 2028

The Best of Both Worlds — Academic Leadership and Financial Reward

We are recruiting an experienced intensivist to serve as the Founding Critical Care Fellowship Program Director. This position offers the unique opportunity to have the best of both worlds: a highly academic leadership role combined with exceptional financial reward. The physician can shape a new training program while maintaining an active clinical critical care practice.

Unlike a conventional academic W-2 employment model, the position is structured through a 1099 employment contract, providing significant financial upside and flexibility while preserving the opportunity to pursue a meaningful academic career. Combined with competitive clinical compensation and a separate Program Director stipend, total annual compensation is expected to exceed $550,000, with the potential to exceed $600,000.

The hospital anticipates pursuing accreditation for a fellowship targeted to begin in 2028, and the Program Director will work closely with Graduate Medical Education and physician executive leadership throughout program development, the accreditation process, faculty development, curriculum design, recruitment, and ultimately fellow selection and education.

Unlike joining an established fellowship with longstanding systems already in place, this position provides the incoming Program Director with the opportunity to shape the culture, expectations, curriculum, and educational philosophy of the program from the beginning. The position combines protected Program Director time with active clinical practice as an intensivist at the hospital.

Program Director Qualifications

The ideal candidate will have:

• Previous experience as a Program Director or Associate Program Director within an accredited GME program; or
• Significant and sustained involvement in Graduate Medical Education with experience as core faculty and demonstrated leadership in resident or fellow education.
• Exceptional candidates without prior PD/APD experience may be considered if they have an extensive record of GME participation, curriculum development, resident or fellow education, faculty leadership, and academic involvement.

Responsibilities are expected to include:

• Fellowship curriculum development
• Development of educational goals and competency standards
• Faculty recruitment and development
• Establishing evaluation and feedback systems
• Development of didactic and bedside educational programs
• Participation in the accreditation application process
• Preparation for accreditation review
• Development of fellowship recruitment and interview processes
• Participation in fellow selection
• Establishing expectations for clinical performance, scholarship, professionalism, and accountability
• Building the culture of the fellowship before the first fellow arrives

The Program Director will have an unusual opportunity to establish these standards rather than inherit them. Our educational philosophy emphasizes developing intensivists who are clinically independent, confident, accountable, and exceptionally strong at the bedside. Emphasis is placed on recognizing the subtle signs of evolving critical illness before the patient becomes obviously unstable, understanding physiology rather than simply following protocols, developing sound clinical judgment, and knowing when independent decision-making is appropriate versus when additional expertise should be sought.

ICU Structure
The critical care service includes:

• 24-bed Main ICU
• 8-bed Neurocritical Care ICU
• Average Census 12-15 patients per intensivist.
• Two intensivists covering the ICU during the 7:00 AM–7:00 PM day shift
• One intensivist covering the ICU during the 7:00 PM–7:00 AM night shift

During the higher-volume winter months of December through February, an additional intensivist is staffed in the Neurocritical Care ICU for eight hours during the daytime, reducing the Neuro ICU cross-coverage responsibilities of the two primary daytime intensivists. A dedicated physician call room is available near the ICU for the nighttime intensivist.

Clinical Scope

Candidates must be comfortable managing a broad medical-surgical critical care population. Clinical responsibilities include traditional medical critical care as well as postoperative surgical patients, including:

• Medical critical illness
• Sepsis and septic shock
• Acute respiratory failure and mechanical ventilation
• Complex multisystem organ failure
• Surgical critical care
• Postoperative cardiovascular care
• Postoperative coronary artery bypass graft patients
• Hemodynamic instability and shock
• Mechanical circulatory support

The hospital is not currently an ECMO center, but the hospital has a strong institutional interest in developing a comprehensive cardiogenic shock program. The institution does occasionally manage patients requiring advanced mechanical circulatory support, including ECMO and Impella support, including Impella CP, 5.0 and, when appropriate, 5.5. Experience with cardiogenic shock, advanced hemodynamics, mechanical circulatory support, and development of multidisciplinary shock programs is therefore desirable.

Neurocritical Care

The hospital maintains a dedicated 8-bed Neurocritical Care ICU.

Within the Neuro ICU:

• The Intensivist functions as the primary attending physician.
• Neurocritical care consultation is available for collaborative case management.
• Neurosurgical support is available.
• Neuro-interventional support is available.

Candidates should be comfortable serving as the primary intensivist for critically ill neurologic and neurosurgical patients while collaborating closely with neurologic, neurosurgical, and neuro-interventional specialists.

Resident Education:

The hospital currently has an Internal Medicine residency program. The ICU typically has approximately five Internal Medicine and Transitional Year house staff rotating each month, with resident coverage also available overnight. Anesthesia & Emergency Medicine Residency Program development is also in progress. Teaching is consequently an integral part of daily ICU practice rather than an occasional responsibility.

The Program Director candidate should enjoy bedside education and be comfortable integrating teaching into multidisciplinary rounds while maintaining efficient, high-quality patient care. Education extends beyond physicians. We place significant value on teaching and collaborating with nurses, respiratory therapists, residents, and other members of the multidisciplinary ICU team.

Procedural Expectations

Candidates should possess a broad contemporary critical care procedural skill set.

Expected competencies include:

• Endotracheal intubation
• Central Venous Catheter Placement
• Ultrasound-guided vascular access
• Radial arterial catheter placement
• Femoral arterial catheter placement
• Therapeutic bronchoscopy
• Thoracentesis
• Paracentesis
• Chest tube placement
• ICU point-of-care ultrasonography (POCUS)

Candidates should be comfortable incorporating bedside ultrasound into routine critical care decision-making and procedural practice. Additional skills such as fiberoptic intubation and percutaneous chest tube placement are highly desirable.

Quality Culture

The ICU has undergone a substantial clinical and operational transformation over a relatively short period, and the program has demonstrated major improvements in areas including:

• ICU mortality performance
• Healthcare-associated infections
• ABCDEF bundle performance
• Nursing and multidisciplinary compliance with evidence-based critical care practices
• Stewardship
• Standardization of ICU care

Leadership Culture and Candidate Characteristics

Personality and leadership style are extremely important for this position.

We are a physician-led organization with highly engaged executive leadership. The group's CEO and senior physician leadership maintain a presence in the ICU. Leadership visits are intended to support physicians and residents, remain connected to frontline clinical operations, observe workflows and rounds, identify opportunities for improvement, and provide both group and individual feedback. Candidates should be comfortable working within a high-engagement, physician-led organization with active executive involvement and a strong feedback culture.

• Strong interpersonal and communication skills
• Patience and enthusiasm for teaching
• Commitment to resident and fellow development
• Collegiality
• Professional accountability
• Receptiveness to constructive feedback
• Willingness to provide constructive feedback to others
• Flexibility when clinical circumstances change
• Willingness to support colleagues when additional help is needed
• Commitment to multidisciplinary teamwork
• High standards for clinical quality
• Interest in continuous improvement

Clinical Commitment and Compensation

The anticipated clinical commitment is a minimum of approximately 10 ICU shifts per month in addition to Program Director responsibilities. The clinical schedule will include daytime and possibly nighttime coverage. Night shifts are not expected to represent more than approximately 30% of the clinical schedule.

The position includes:

• Competitive intensivist clinical compensation
• A separate Program Director leadership stipend
• Combined annual compensation expected to exceed $550,000
• Depending upon clinical commitment and responsibilities, total annual compensation has the potential to exceed $600,000